Alzheimer's Patch Could Replace Pills

The first patch designed to deliver a widely used Alzheimer's medication via the skin appears to minimize side effects while being easy to use, Swedish researchers say.

[harvey weintraub md]

how can I purchase?

[Mark Pippenger MD]

This patch (the rivastigmine patch) will not be replacing pills anytime soon. The drug itself isn't that widely-used--it's the least-used of the three cholinesterase inhibitors, because of its higher risk of adverse effects. The patch is a little less likely to have those adverse effects, but it appears (from the only controlled trial yet published) to have around half the cognitive efficacy of other treatments (the company claims it worked just as well as "high-dose" rivastigmine capsules, but read closely--the study allowed dose reductions for tolerability, they weren't on the "full" dose of 12 mg daily, more like 9 mg daily of the pill), and it's much less convenient (the patch must be replaced daily, and you must be careful not to place the new patch in a spot where there has been a patch in the previous several days). Since rivastigmine doesn't work any better than donepezil or galantamine, there's no rationale to try urgently to get people on rivastigmine. I take care of hundreds of patients with Alzheimer disease, and I can just about guarantee that if the patient can't at least get a pill into their mouth (with the ODT formulation of Aricept (donepezil) the pill dissolves in the mouth, so that they don't even have to swallow), they don't need to be on treatment.
It's just a big marketing ploy.

[Mary Singer MD]

the Patch is a great product..it has very few to none drug to drug interactions unlike donepezil and galantamine...and does not pass through through the liver....overall a safe and effective product when you think of how many elderly patients are on other medications...by the way donepezil 5mg and 10gm are not clinically significant....also a marketing ploy